<?php

?>

<div class="row">
	<fieldset>
	<legend class="label">New Student Assessment &amp; Application Form</legend>
	<?if(isset($system_message))echo $system_message;
	echo validation_errors('<div class="error">', '</div>');
	?>
		<?echo form_open('student_assessment_application/student_assessment/'.$enrollment_id);?>
		
		<div class="input-block">
			<label class="radius secondary label">Schedule of Testing</label>
			<input type="text" name="requirements_for_admission" value="<?=set_value('requirements_for_admission',$requirements_for_admission);?>">
		</div>
		
		<div class="clearfix"></div>
		
		<div class="input-block">
			<label class="radius secondary label">Age</label>
			<input type="text" name="requirements_for_admission" value="<?=set_value('requirements_for_admission',$requirements_for_admission);?>">
		</div>
		
		<div class="clearfix"></div>
		
		<div class="input-block">
			<label class="radius secondary label">How did you hear of us:</label>
			<?=form_checkbox('hear_from', 'Billboard', FALSE, 'class="left"');?>&nbsp;Billboard
		</div>
		
		<div class="row">
			<div class="small-9 columns">
			<input type="hidden" value="<?=$enrollment_id;?>" name="enrollment_id" />
			 <?php
				
				echo form_submit('save_and_print','Save and Print','class="button tiny"');
				echo form_close();
			?>
			</div>
		</div>
		</fieldset>
		
	<div>
		<a href="#" onClick="parent.history.back(); return false;" class="btn btn-success"><b>Go Back.</b></a>
	</div>
</div>
